Estrogen Atrophy & Menopause

If your doctor suspects that estrogen atrophy and menopause has made your bladder more sensitive, look for products that are calming, soothing and support the health of the bladder wall will be a priority.  The key ingredient to look for is chondroitin which has been found in research studies to help restore the surface integrity and recovery of the bladder wall.(1) 

Key Patient Education Tips

  1. The bladder wall has three key layers: (1) an outer mucosal layer that provides protection, (2) several layers of urothelial cells and (3) at the deepest level, blood vessels, nerves, mast cells and the smooth muscle of the bladder wall.
  2. The mucosal (GAG) layer is estrogen dependent. When you are young and have lots of estrogen, you have a thick mucosal layer. When you are older, had a hysterectomy or are undergoing chemical menopause, you'll notice that your skin gets dryer, especially "down there" on your mucus membranes.  This allows urine to penetrate deeply into the tissue where it will trigger irritation and/or pain. This is not a disease. This is the result of aging.
  3. One common sign of estrogen atrophy is a burning sensation on the vulva as urine is passing over it during urination. This is because the vulvar skin is dryer and more sensitive. 
  4. The urethra is often the first to respond to dropping estrogen levels. Patients may feel urethral irritation and/or feeling like a drop of urine is stuck in your urethra. 
  5. Most clinicians first discuss the use of a hormone product, such as topical estrogen, to help your tissue produce more mucus. This can be remarkably helpful for many. Take the time to learn the pros and cons of hormone therapy, as well as the difference between systemic (oral) vs. topical (cream) therapy. Topical estrogen therapy is considered far less risky than oral therapy. 
  6. Drinking water is essential to bladder health. Water dilutes urine, thus reducing the potential irritation that the chemicals in urine can cause. Spring water is ideal. 
  7. Dehydration causes urine to become more irritating. Some patients, however, stop drinking water in a mistaken attempt to reduce frequency. This actually makes the bladder more irritated. 
  8. No therapy (alternative or traditional) will force the bladder to heal. It takes time, patience, determination, a wilingness to protect your bladder and follow the diet, and so forth.
  9. Diet modification is essential because your bladder can't defend itself like it could when you were younger. Foods high in acid, caffeine can trigger more pain and discomfort and may need to be avoided. Even one cup of coffee a day can create long term pain and discomfort. 
  10. Your goal is to protect and comfort your bladder, as well as to soothe more tender skin on your vulva, vagina, etc. 

Nutraceutical Options

The American Urology Association suggests that patients try OTC nutraceuticals in Step One of their Guidelines for IC/BPS. Here are some options that you can consider: 


AloePathBladder BuilderBladder Rest
ALOEPATH® - For a soothing and pain reducing effect

BLADDER REST® - For a simple chondroitin based protective effect

BLADDER BUILDER® - Our most comprehensive formula provides a coating, soothing, pain reduction and biome support

PRVNT® - For the prevention of urinary tract infections

PEAORA®
 - For chronic pain relief

Prelief® - To reduce acid in some foods. 

*It's not unusual for some to have sensitivities to various ingredients. Please review the label carefully for any known allergens. We suggest starting small. Try one capsule and see how your body handles it. If you feel good, try one a day for a week and again assess. If you are doing well, you can gradually increase to the manufacturers recommended dosages. Of course, if you struggle with any side effects, stop the supplement and talk with your physician.

Topical Therapeutics
 

V-Magic - For dryness on the vulva

Luvena Vaginal Moisturizer & Lubricant - For vaginal dryness

Luvena Personal Moisturizer - For intimacy and lubrication


Personal Hygiene


Basis Soap For Sensitive Skin -
For skin made more sensitive due to dryness and estrogen atrophy

Perineal Wash Bottle - To rinse all urine residue from your skin after urination. 

Reference: 

1. Rozenberg BB, et al. IMPROVING THE BARRIER FUNCTION OF DAMAGED CULTURED UROTHELIUM USING CHONDROITIN SULFATE. Neurourol Urodyn. 2019 Nov 27.

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